One of my good friends is pregnant. She is at that stage early in the second trimester when the first ultrasound is usually recommended. She is choosing a home birth, but comes from a medical family who would like her to have an ultrasound. She has medical insurance, but it does not cover any pregnancy related expenses until after her deductible is reached. An ultrasound would cost about $2000. Like many parents choosing a home birth, my friend is debating the necessity of this routine procedure.
Why are ultrasounds recommended? One purpose of an ultrasound is to pinpoint more accurately the due date of the baby. If you know the first day of your last period and can count 40 weeks ahead, you can get a really good estimate of when your baby will arrive. Each baby is different, and no test or method can pinpoint the exact date of birth, unless of course you plan to induce.
Another reason to have an ultrasound, especially for older mothers, is to rule out certain birth defects. If you have already made up your mind not to abort a child that has a defect, do you really want to know so many months in advance? The problem with prenatal care in the United States, including the books that are written, is they seem to be all about what could go wrong rather than celebrating what goes right. In utero stress has been found to put children at risk.
My son was born with a congenital heart defect. When he had his corrective surgery, a nurse asked if I had had an ultrasound. I was treated like a horrible mother for not having one, as if I had endangered my baby’s health by not choosing to ultrasound. The truth is my son’s heart defect would only have been discovered on a Level II ultrasound, which is only used if indicated by a routine ultrasound, and my pregnancy would have been wrought with anxiety had it been discovered. Most likely, I wouldn’t have had a home birth either. Some people may feel I was irresponsible by not having an ultrasound, but we still wouldn’t have known about my son’s heart until he was born.
According to Obstetric Ultrasound, there are eight purposes for an ultrasound:
1. Diagnosis and confirmation of early pregnancy.
2. Vaginal bleeding in early pregnancy.
3. Determination of gestational age and assessment of fetal size.
4. Diagnosis of fetal malformation.
5. Placental localization.
6. Multiple pregnancies.
7. Hydramnios and Oligohydramnios.
8. Other areas.
MedicineNet.com states an early pregnancy ultrasound is used only to determine:
- Presence of more than one fetus.
- Your due date or gestational age (the age of the fetus).
If you are contemplating having an ultrasound, it is important to weigh what you would do with this information. If you do not view it as vital or that the information would not change anything for you and your partner, than an ultrasound may not be necessary for you. Sure, you won’t get that cute little picture to hang on the refrigerator or know the sex of your baby, but I think you can live without that.
So why wouldn’t you want an ultrasound? In my personal experience it was one less test, less medical expense, and less anxiety. There is some fear that an ultrasound is hazardous, but some studies refute this. Suite101 reports:
In the last 30 years, no conclusive evidence has shown that the levels of ultrasound used on humans are harmful. However some animal studies with higher levels of ultrasound have indicated changes in cell structure or function and even cell death. These studies seem to indicate that the tissue or body part that was being examined under the high frequency waves was altered in some way.
As a result the NIH has released the following statement, “ultrasound examination in pregnancy should be performed for a specific medical indication.”
I do not think that determining a due date or the presence of multiple fetuses is a “specific medical indication”, especially considering there are other methods form making these determinations.
The World Health Organization has even questioned the validity and reliability of ultrasound studies. Midwifery Today reports:
At a 1982 World Health Organization (WHO) meeting sponsored by the International Radiation Protection Association (IRPA) and other organizations, an international group of experts reported that “[t]here are several frequently quoted studies that claim to show that exposure to ultrasound in utero does not cause any significant abnormalities in the offspring. …However, these studies can be criticized on several grounds, including the lack of a control population and/or inadequate sample size, and exposure after the period of major organogenesis; this invalidates their conclusions….”
Early studies showed that subtle effects of neurological damage linked to ultrasound were implicated by an increased incidence in left-handedness in boys (a marker for brain problems when not hereditary) and speech delays.(5) Then in August 2006, Pasko Rakic, chair of Yale School of Medicine’s Department of Neurobiology, announced the results of a study in which pregnant mice underwent various durations of ultrasound.(6) The brains of the offspring showed damage consistent with that found in the brains of people with autism. The research, funded by the National Institute of Neurological Disorders and Stroke, also implicated ultrasound in neurodevelopmental problems in children, such as dyslexia, epilepsy, mental retardation and schizophrenia, and showed that damage to brain cells increased with longer exposures.
This post is not to be construed as medical advice, but it is meant to provoke parents into questioning the necessity of “routine” procedures that could turn into anxiety provoking medical interventions that do not affect outcome. Examining one’s beliefs and thoughts on the potential results can help parents decide if an ultrasound is worth the extra expense and if it would really give you the peace of mind it intends.
Thanks for sharing this. It really is important for parents to question whether or not they really need all the “medicine” that doctors want to offer them. I’ve read other articles that say pelvic exams don’t give you much useful information either, even during labor, and comes with its own risk of infection. Why do something so invasive and uncomfortable if it doesn’t even help?
I appreciate reading about your perspection on ultrasounds. Although I also tend to shy away from unnecessary medical procedures, I didn’t consider the ultrasound to be unnecessary when I was pregnant. I couldn’t even remember what month my last period had been and had no clue to the due date. The doctors thought that was strange, but an ultrasound let them (and me) know how far along I was.
Far from causing stress, my ultrasound appointments were exciting. It gave me a chance to see my baby move and feel an early bond. It also helped my husband bond with our baby. I left feeling good about my baby’s health and development, and that helped me feel more secure in the pregnancy.
That was a typo. I meant to say “perception,” not “perspection.” Ha.
With my first pregnancy, my midwife recommended an early u/s for dating. This insulted me, I knew when I conceived. I went ahead with it any way because I had a lot of cramping, not a lot of symptoms and feared something terrible like ectopic pregnancy. I hated every second of it. It’s a cold experience. Later, I miscarried and discovered the baby had stopped growing 1 day after the u/s. It’s a silly connection to make, but now that I’m expecting again, I can’t bring myself to go in for another early u/s.
However, I do think one is necessary after 18 weeks or so. Why? I am giving birth at a birth center. What if something is seriously wrong? I would want to be prepared for that. And by prepared I mean, give birth in the hospital if it’s something my midwives believe they cannot handle. I can’t even imagine how the doctors treat home birth/birth center women when newborns are brought in for medical attention. That experience would not end well for me. Smug doctors + post-birth me = disaster.
I agree with Brooke that one (hopefully, if all goes well) ultrasound around 20 weeks isn’t necessarily a bad idea. I birthed at an independent birth center, and my 20 week ultrasound showed a placenta previa. Fortunately, it had moved when I had another one around 37 weeks, but if it hadn’t, I definitely wouldn’t have wanted to find out during labor. I’m sure there are other conditions as well that would be better found early. I’m also a fan of finding out the sex, although I totally admire families with more patience!
I had ultrasound with my first baby, which was helpful as I ended up with a very long pregnancy going to 44 weeks, without the early ultrasound that pushed my dates back a week, I would have been facing a 45 week pregnancy, and I don’t know if I could have managed that.
Second and third pregnancy I declined ultrasound. My husband found it quite difficult to connect with the pregnancy with no ultrasound, but bonded straight away at the birth. By our third baby, he was resigned to no ultrasound! Another wonderful homebirth and he was beautifully bonded again.
I love no intervention, I’ve seen friends go through agonies after false positives and delays in diagnoses. I love the peace and intimacy of my pregnancies, just my baby and me. I don’t need to see baby is there on a screen, our bond is deeper than that.
I accept each to their own, but I wish more people would think harder about their decisions.
Wow! I had an OB/GYN as back up to my home birth midwife and had an early scan at 7 weeks with the OB/GYN. Then another at about 20 weeks. My son is left-handed and didn’t start talking until 18 months. But now he won’t stop talking and has been speaking in perfect 12-15 word sentences since 2.5 years old! That stat about these things being a marker for brain problems later is worrisome though. Not sure if I would do an early scan next time.
Oh, I checked out your husband’s food blog. Ironically the kitchen tool he is talking about is from my good friend’s (hubby & twin brother’s) company here in England. They are the sweetest most gracious people, too. (Even though we don’t use too much plastic in our house) 🙂
Jennifer Lance says
My husband doesn’t have a food blog.
Oh, I guess that comment was for the most recent post by Danielle Friedland from Healthy Child Healthy World, not your post. Oops.
Jen Chendea says
You neglected to mention molar pregnancy, a condition which occurs in roughly 1 in 2,000 pregnancies, is life-threatening, and can easily be detected by ultrasound, and then treated. I also believed in avoiding ultrasound, which is why my molar pregnancy advanced to 14 weeks until it was detected. You can read a short version of my story on my blog.
Maybe it isn’t necessary for all pregnancies, but in many cases it can be well warranted. For example, I had vaginal bleeding and ultrasound discovered an ectopic pregnancy. The second time around, I had an ultrasound to rule out another ectopic, but instead of an ectopic, I had a blighted ovum with zero symptoms. I miscarried naturally eventually, but I’m so glad I found out early. After my first loss I was heartbroken and had been confident about seeing a heartbeat this time. If I’d been blissfully happy and then miscarried naturally instead of having someone break the news to me gently, I don’t know what the emotional trauma would have been. Next time I’m pregnant I will definitely have an ultrasound (I’d probably be nuts not to).
Momma Jorje says
Thanks for this though-provoking article. I managed my first pregnancy with no U/S at all – that was two decades ago and I was a teen. With my next pregnancy, I was allowed 1 U/S because my uterus was supposedly over-sized so twins were a possibility. I understand why you (and others) might think this is not necessary information, but I think it would be VERY helpful to know as far as any “things” you need to have (enough cloth diapers, etc).
By the time I was pregnant with my 3rd daughter, I was of “advanced maternal age” plus I had a threatened miscarriage. This meant I got U/S at almost every appointment! I also got the fancy 3D one.
Now I’m pregnant again (and still old, of course). So I’m supposed to get an U/S soon to check for signs of Down Syndrome. I really WOULD like to know this information, even though we will not terminate. I’m not sure if *I* would choose to terminate, but I know my husband would not, so that removes the option. However, if we found out that we ARE having a DS baby, I’d want the time for finding a support group and researching the hell out of it to prepare myself. I’d rather freak out a little now and be prepared than freak out AT birth.
That said, my husband will also want an U/S to determine the sex. And since I’m still old, they’ll want to do the 3D U/S again. I’m not sure what I think about this… but your post definitely has me thinking about it. I’ll check out any other responses for links on FB, too. Yours was the first link I saw. Thanks!
Jennifer Lance says
You have to do what you and your husband feel is right, and you make a good point about preparing ahead of time. I don’t know specifically your age or if you have had other tests that may indicate DS. It is important to discuss with your medical provider and an alternative provider if you have concerns. It is a lot to consider.
Momma Jorje says
I’m 38 years old. It is so much to consider… and just one of so many topics that require such consideration when becoming a parent (even if you’ve done it before).
Momma Jorje says
Thanks again for such a great, thought-provoking post! I included it in my Sunday Surf.
My midwife supports me not getting any and says that they are usually of no medical benefit. 1 in the 4000 babies she delivered had a problem caught by an ultrasound that saved its life knowing ahead of time. The only thing i would like to get one for is to check placenta position toward the very end of pregnancy. She said if i want to just get one to do 20 weeks because they can see everything the best. but im wondering about just getting one like around 36 weeks?
Jim West says
Cost/Benefit of ultrasound needs to be reevaluated due to new information.
Webb/Mourad 2016 is a recent human study that finds risk and advocates for FDA modifications.
A New Bibliography lists 50 human studies, thereby indicating extreme risk of ultrasound, such as fetal region DNA fragmentation as clinical intensities.
Millie Hue says
Thanks for pointing out that having an ultrasound will help you have an idea if the baby inside you is as healthy to keep them from health risks. I will definitely follow your advice when the time comes that I can get an ultrasound. I just found out that I am pregnant after trying a PT at home since I am three weeks delayed. This information is really helpful.